Total knee replacement in valgus knee / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the methods and clinical results of total knee replacement (TKA) in patients with valgus knee deformity.</p><p><b>METHODS</b>Between January 1996 and August 2004, 87 TKAs were performed by means of medial parapatellar approach, standard osteotomy and only lateral soft tissue release with posterior stabilized implants on 74 patients (11 men and 63 women) with valgus deformity. The average age at the time of operation was 62.93 years (range, 26-80 years). Clinical and radiographic evaluations including range of motion (ROM), Knee Society Score System (KSS) and the tibial and femur angle (T-F angle) were performed at follow-up.</p><p><b>RESULTS</b>After a mean follow-up of 33.8 months (range, 5 months-9 years), the average ROM improved from 91 degrees (range, 70 degrees-120 degrees) preoperatively to 112.4 degrees (range, 80 degrees-130 degrees) postoperatively, the average KSS improved from 22.7 points (0-48 points) preoperatively to 81.7 points (range, 71-93 points) postoperatively. The average function score improved from 26.5 points preoperatively to 86.3 points postoperatively, the average T-F angle was corrected from 21.59 degrees (range, 12 degrees-40 degrees) of valgus preoperatively to 8.7 degrees (0 degrees-11 degrees) of valgus postoperatively. One knee had lightly instability at follow-up, one knee with patellar dislocation preoperatively had subdislocation postoperatively, no other complication occurred.</p><p><b>CONCLUSIONS</b>The techniques of medial parapatellar approach, standard osteotomy and only lateral soft tissue release with posterior stabilized implants can correct a fixed valgus deformity very successfully in patients undergoing primary total knee replacement, and provides excellent results.</p>

A comparison study of interbody cage in lumbar degenerative disease / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the advantages and disadvantages of TFC/BAK, Prospace and Brantigan I/F carbon cages and summarize their applications.</p><p><b>METHODS</b>One hundred and twelve cases of Brantigan I/F, 123 cases of TFC/BAK and 45 cases of Prospaces were used in the treatment of degenerated lumbar disorders. The clinical results and complications were observed and analyzed.</p><p><b>RESULTS</b>All devices restored the height of intervertebral space and achieved immediate stability after insertion. One hundred and twelve cases of Brantigan I/F cages were solid fused, the clinical results were satisfactory. Three cases of TFC/BAK cages subsided into the vertebra and 2 cages retropulsed slightly during follow-up. There was no serious complications of nervous system, but the operation time and amount of bleeding in Brantigan I/F group increased.</p><p><b>CONCLUSIONS</b>Carbon fiber intervertebral cages are an effective method in treating degenerated lumbar disorders. To avoid complications, the indications and techniques must be selected carefully.</p>

Surgical treatment of degenerative scoliosis / 中华外科杂志

<p><b>OBJECTIVES</b>To investigate the techniques of posterior lumbar interbody fusion and pedicle screws in the treatment of degenerative scoliosis and evaluate their clinical significance.</p><p><b>METHODS</b>Twenty five patients with degenerative scoliosis were treated operatively during 1997 - 2002. Among the 25 patients, 13 patients were treated with Brantigan I/F carbon cages in 28 intervertebral spaces, 7 patients were treated with Prospace cages in 15 spaces, 1 patient was treated with CONTACT cages in 2 spaces. The correcting effects, complications and follow-up results were analyzed retrospectively.</p><p><b>RESULTS</b>The average correction rate of scoliosis was 59% and the rate of pain relief was 88%. There was a case of pseudoarthritis and a case of embolism. During follow-up, correction rate and height of disc spaces were not lost nor shift of interbody cages.</p><p><b>CONCLUSION</b>Posterior pedicle screws combined with interbody fusion is a safe and effective treatment for degenerative scoliosis.</p>

Application of intervertebral carbon fiber cage in degenerated lumbar disorders / 中华外科杂志

<p><b>OBJECTIVES</b>To evaluate the effect of intervertebral carbon fiber cages in the treatment of degenerated lumbar disorders.</p><p><b>METHODS</b>One hundred and twelve patients of degenerated lumbar disease were analyzed retrospectively with regard to the effect of posterior lumbar interbody fusion (PLIF) using intervertebral carbon fiber cage.</p><p><b>RESULTS</b>In the 112 patients, disc height was 7 mm (3 to 11 mm) on average before operation and 11.2 mm (8 - 14 mm) after operation. Cobb angle was 32 degrees (21 degrees to 42 degrees ) on average before operation and 18.9 degrees (13 degrees to 21 degrees ) after operation. After follow-up for 7.8 months (4 to 13 months) on average, all operative disc spaces showed solid arthrodesis through X-ray images. Disc height was 10.9 mm (8 - 14 mm) on average, and Cobb angle was 18.5 degrees (13 degrees to 21 degrees ) on average. During the follow-up, endplate absorbing, pseudo-articulation, cage displacement, subsidence, and breaking were not found.</p><p><b>CONCLUSION</b>Implantation of intervertebral carbon fiber cages is an effective method for the treatment of lumbar degenerative disease. Accurate indications and skilled techniques are required to avoid complication.</p>